Atrial septal defect echocardiography
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Atrial septal defect echocardiography On the Web | |
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American Roentgen Ray Society Images of Atrial septal defect echocardiography | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [[2]]; Cafer Zorkun, M.D., Ph.D. [3]; Assistant Editor(s)-In-Chief: Kristin Feeney, B.S. [[4]]
Overview
Echocardiography is the preferred diagnostic tool in the evaluation of an atrial septal defect. As an evaluative tool, echocardiograms can: locate the defects, identify the direction of shunting, identify associated anomalies, evaluate atrial and ventricular enlargement. In general, an atrial septal defect patient will present symptomatic evidence of hemodynamic disruptions between the left and right atriums.
Indications
Echocardiography is the preferred diagnostic imaging method for the evaluation of many congenital heart diseases, including atrial septal defect. An echocardiogram allows for identification of the functional issues with the heart's anatomy. In suspected atrial septal defect patients, an echocardiogram can:
- Locate the defect
- Identify the direction of shunting
- Identify associated anomalies
- Evaluate atrial enlargement
- Evaluate ventricular enlargement
There are many types of echocardiography imaging beneficial for atrial septal defect diagnosis.
Advantages
In transthoracic echocardiography, an atrial septal defect may be seen on color flow imaging as a jet of blood from the left atrium to the right atrium. If agitated saline is injected into a peripheral vein during echocardiography, small air bubbles can be seen on echocardiographic imaging. It may be possible to see bubbles travel across an atrial septal defect either at rest or during a cough. (Bubbles will only flow from right atrium to left atrium if the RA pressure is greater than LA). As better visualization of the atria is achieved with transesophageal echocardiography, this test may be performed in individuals with a suspected atrial septal defect which is not visualized on transthoracic imaging.
Newer techniques to visualize these defects involve intracardiac imaging with special catheters that are typically placed in the venous system and advanced to the level of the heart. This type of imaging is becoming more common and involves only mild sedation for the patient typically.
If the individual has adequate echocardiographic windows, it is possible to use the echocardiogram to measure the cardiac output of the left ventricle and the right ventricle independently. In this way, it is possible to estimate the shunt fraction using echocardiography.
Specific Techniques for ASD
Techniques in specific defects: Ostium primum | Ostium secundum | Sinus venosus | Coronary sinus